Hypertension: Effects and Prevention

Hypertension, also known as high blood pressure, has become a major risk factor for several types of heart disease across the globe. In the United States alone, nearly 70 million adults have been diagnosed with this condition [1]. Hypertension is a condition in which arterial walls experience extreme force from blood flowing through; long-term force against artery walls will lead to more serious health problems such as stroke, renal failure, and other cardiovascular diseases [2]. If the proper steps to treat hypertension are not taken, patients have a high risk of developing atherosclerosis, a condition that causes arteries to harden significantly. Smoking, obesity, lack of physical activity, high alcohol consumption, and high sodium intake are factors that may cause an individual to be diagnosed with hypertension [3] Detection of hypertension is crucial in order to reduce the incidence of death by cardiovascular disease [1].

The algorithm begins with an indication that is used for adults over the age of 18 and noted that lifestyle interventions should be continued throughout management. Goal blood pressures are separated by age and presence of chronic disease. The goal for patients over 60 is SBP < 150 mmHg and DBP < 90 mmHg. The goal for patients under 60 is < 140 mmHg and DBP < 90 mmHg. Different goal values are presented for patients with chronic conditions. Treatment with medication is categorized by: general population nonblack, general population black, chronic conditions black, and chronic condition all races. Based on the algorithm black patients should only be prescribed thiazide type diuretics and/or calcium channel blockers. While non-black patients can take all of the medications listed in JNC 8 (thiazide type diuretics, ACEI, ARB, and/or CCB). If patient does not reach goal blood pressure then three strategies are listed, along with lifestyle adherence. The algorithm also explains not to use ACEI and ARB together. The final option for patients not at goal blood pressure includes additional medications and/or referral to physician with an expertise in hypertension

The concern on whether anti-hypertensive’s should be withheld in patients who are hypertensive has been debatable in the recent past. Generally, the treatment of hypertension among hospitalized patients is basically an opportunity to enhance the recognition and treatment of blood pressure (Axon, Nietert & Egan, 2011, p.246). This is mainly because hypertension is a basic risk factor for heart diseases, stroke, and death whose impact is widespread to nearly 70 million adults in America. There have been numerous educational initiatives and publication of treatment processes to address this condition in the past few decades. Despite these measures, nearly 39 million Americans are at risk of hypertension because they have not reached their desired or optimal blood pressure.

Hypertension is a developing problem worldwide associated with an increased risk of cardiovascular morbidity and mortality. In 2020, the world population will be approximately 7.8 billion people, and there will be 1 billon people who may be affected by hypertension (Tomson & Lip, 2005). One in three adults in the United States has high blood pressure. According to the report “Health, United States, 2010 with Special Feature on Death and Dying,” the prevalence of hypertension among adults 20 years old or older increased from 24% to 32% during 1988-1994 and 2005-2008. The African-American population has a higher prevalence of this health condition than white Americans do. In 2005 to 2008, the prevalence of hypertension among black males (41.4%) was more than 10%,

High blood pressure increases your risk for heart disease and stroke, two leading causes of death for both Florida and the United States (Centers for disease control, 2017). High blood pressure, also called hypertension, is known as the “silent killer” because it often has no warning signs or symptoms, and many people do not know they have it. Hypertension damages blood vessels in the organs, reducing their ability to work properly (National institute of diabetes and digestive and kidney diseases, 2016). About 1 of 3 U.S. adults—or about 75 million people—have high blood pressure. Only 54% of these people have their high blood pressure under control (Centers for disease control, 2017). Hypertension education, which focuses on controlling the disease with medication, diet, and losing weight, is important in preventing or delaying the progression of serious complications. Most people diagnosed with hypertensive disease will need to see a medical professional who will recommend lifestyle changes to help you control and prevent high blood pressure (Ignatavicius & Workman, 2006, p. 1742).

The major health problem selected for this project was hypertension (Harrison et al, 2011). It is identified as a cardio vascular disease risk factor such as dementia, chronic kidney disease, coronary heart disease, and stroke (NICE, 2011). It can be missed easily, as in various instances it is asymptomatic as well as it is also known as a silent killer. The Hypertension is thought to be a disease of vascular regulation ensuing from arterial pressure control mechanisms malfunction (extracellular fluid volume, rennin-angiotensin-aldosterone system, and CNS) that results in elevation of BP by means of enhanced peripheral vascular resistance, and cardiac output. There are 2 basic hypertension types. Around 90 to 95 percent of the individuals have primary hypertension which is linked with change in lifestyle as well as needs medical treatment. On the other hand, 5-10% has secondary hypertension which is linked with various other diseases for instance pregnancy, thyroid, and renal (Haslam and James, 2005). It is estimated that around 1 in 20 adults will have increased BP of 160/100 mmHg and above that results in either more than one predisposing aspects (Gemmell et al, 2006).

Machado et al. did not address the scope of the problem or consequences of the problem in the problem statement. However, these items were identified in the introduction leading up to the problem statement as complications of uncontrolled HTN with low rates of adherence to treatment associated with advanced age and disparaging public health factors (Machado et al., 2017). The problem is identified as systemic arterial hypertension (SAH) requiring treatment changes that might be difficult to institute or maintain for the elderly population due to various factors (Machado et al., 2017). Machado et al. briefly address the background and knowledge gaps as aspects related to culture, the health environment and individual capacities (2017). A proposed solution is introduced in the problem statement to build a relationship with the HTN patient to with the patient in corroborating on a plan of care that the patient is able understand and will follow through with (Machado et al.,

Modern medical advancements have significantly decreased the prevalence and severity of infectious disease as well as the treatment of acute, traumatic conditions. Pharmacological research has also gained insight into the management of chronic disease. Still, there is an epidemic of chronic, treatable diseases like stroke, heart disease, and kidney disease. Hypertension proves to be the underlying factor associated with these diseases. Hypertension is often referred to as the silent killer because of its indication in deadly disease, and the importance of monitoring ones blood pressure is vital. Lifestyle, diet, and genetic predisposition are all factors of high blood pressure. Chronic high blood pressure above safe levels, known as hypertension, puts elevated physical stress on the renal and cardiovascular systems. By controlling this factor in patients, healthcare providers can decrease cardiovascular events, improve health outcomes, and decrease overall mortality. Patient education is often overlooked in its role in the control and prevention of high blood pressure. This paper analyzes the causes and physiology behind high blood pressure as they relate to the current nursing interventions. The role of nurses is discussed in relation to patient education regarding high blood pressure, and educational approaches are analyzed.

K.H. is a 67-year-old African-American man with primary hypertension and diabetes mellitus. He is currently taking an angiotensin-converting enzyme (ACE) inhibitor and following a salt-restricted weight loss diet. He is about 30 pounds over his ideal weight. At his clinic visit his blood pressure is noted to be 135/96. His heart rate is 70 beats/min. He has no complaints. His wife brought a blood pressure cuff and stethoscope with her in the hope of learning to take her husband’s blood pressure at home.

Hypertension is sometimes referred to as the silent killer (Aycock, Kirkendoll, & Gordon, 2013). Today it is a public health problem. According to the American Heart Association 2013 Statistical Fact Sheet (2013), one out of every three adults has high blood pressure, which is estimated at 77.9 million people (AHA, 2013). High blood pressure is also referred to as hypertension. Hypertension is a prevalent medical condition that carries with it the risk factor for increased chances of heart disease and stroke (Gillespie & Hurvitz, 2013). Hypertension remains one of the top 10 causes of worldwide disability-adjusted life years (as cited in Drenjančević-Perić et al., 2011). For the estimated 348, 102 deaths in 2009, high blood pressure was listed as the primary or contributing cause of death (AHA, 2013). Despite the health risk associated with hypertension, the diagnoses of high blood pressure continue to rise. By 2030, hypertension is expected to increase by 7.2% from 2013 estimates (AHA, 2013).

Hypertension is one of the leading risks for heart disease and stroke. Your physician may advise dietary or lifestyle changes, or specific medications to lower your blood pressure.

Hypertension is currently a major risk factor for heart disease and stroke, which are leading causes of death in the United States. It is estimated that by 2025, 1.56 billion adults will be living with hypertension. Hypertension affects nearly 1 in 3 adults, which is 67 million people. Hypertension is also known as the silent killer because individuals do not have warning signs or symptoms. There are about 36 million adults with high blood pressure who do not take preventative measures to control it. Children are also being affected by hypertension. An estimated 3% of children suffer from this condition, which is a risk factor for obesity and sleep apnea. Hypertension can be reduced by taking basic preventative measures like changing one’s eating diet, exercising daily and by taking medication if other preexisting conditions exist. However, new approaches of effective early prevention needs to be implemented through policies and curriculum in order for people to be educated and influenced to apply the techniques to their daily life.

Hypertension is defined a consistent elevation of the systolic blood pressure above 140mmHg, a diastolic pressure above 90mmHg or a report of taking antihypertensive medication. Early diagnosis and effective management of hypertension is essential because it is a major modifiable risk factor to cerebrovascular, cardiac, vascular, and renal diseases. The higher the blood pressure, the greater the risk for heart attack, heart failure, stroke, and kidney disease.

Methodology: Prescription pattern of 400 hypertensive outpatients were analyzed on basis of age, percentage of male and female patients, anti-hypertensive drug category, most frequently prescribed hypertensive drug and percentage of one/two drug combination.

Approximately one in every three adult’s ages 20 years old and older are diagnosed with high blood pressure or hypertension. Hypertension affects 78 million people in the United States and is equally prevalent in both men and woman (Crabtree et al., 2013). Hypertension is a major risk factor for cardiovascular disease (Hajjar & Kotchen, 2003). It can lead to stroke, myocardial infarction, renal failure, heart failure, neurological issues, and death if not detected early and not treated properly (James, Oparil, Carter, & et al., 2014). Approximately 9.4 million deaths in 2010 were attributed to high blood pressure (Angell, De Cock, & Frieden, 2015). About 54% of strokes, 47% of coronary heart disease, and 25 % of other cardiovascular diseases are attributed to high blood pressure (Arima, Barzi, & Chalmers, 2011).